Viewpoint

For the health of N.H., expand Medicaid

The legislative session in the N.H. State House has come down to crunch time: The House and the Senate have each passed their respective budgets and are now meeting in a committee of conference to work out the conflicts.

New House revenue proposals, such as an increase in the cigarette tax and a gradual increase in the gas tax that would have boosted bridge and road construction, were killed in the Senate. The Senate’s proposal for expanded gambling at a high-end casino was decisively voted down in the House. So we’re left with the same revenue sources we’ve always had, and our ongoing structural deficit in the New Hampshire state budget. Our only hope is growing the state’s economy. While we came through the Great Recession much better than most states nationally, right now our state economy is not growing as fast as neighboring New England states.

One critical part of the state budget in sharp contention is the expansion of Medicaid, a program that is part of the Affordable Care Act, the federal government’s proposal to pay for several years the full cost of Medicaid extended to tens of thousands of working New Hampshire residents at or near poverty level. It would mean hundreds of millions of dollars each year into the economy, several billion over the next seven years.

The N.H. House and Gov. Maggie Hassan fully endorse our state’s acceptance of these federal funds to cover the uninsured. The Senate, voting on strict party lines, has said they want to “study” the proposal, and delay any implementation of this program.

What would they study? How the uninsured cope with illness or injury, delaying timely doctor visits or foregoing needed medications for fear of out-of-pocket costs? How those same workers may be missing days or underperforming at their jobs because of health impairment? How the care providers, our doctors and hospitals who must treat them once they do make their way to the office or ER, will try to cover the expense by shifting to those who do pay, which one study has shown increases New Hampshire rates by 25 percent? Or what those hospitals will do when government sources of support for uncompensated care diminish? Will the health care sector lose thousands more jobs, as it did two years ago when the last draconian state budget was passed?

It is estimated there are 27,000 millionaires in New Hampshire. We are a donor state to the federal government, i.e., we send more in tax revenue to Washington, D.C., than we get back in federal funds, only about 70 cents return on the dollar. Probably a lot of that is sent by those millionaires among us. Don’t you think it would be a good move to try to get more of that money back, especially since those funds would directly improve the health of citizens, and are a solid support for our health care sector, which is a good source of jobs?

We urge you to contact your senator, especially the Republican senators who voted for the study, and ask them to support Medicaid expansion. For the health of the New Hampshire economy and its citizens, let’s study the effects of expansion on the other side of the vote instead.